Adult Acquired Flat Foot Deformity
The Highlights
Adult Acquired Flat Foot Deformity (AAFFD) is a progressive flattening of the medial (inside) arch of the foot, very often with pain and loss of normal function.
Our team have extensive knowledge and skills in diagnosing which tissues are affected from physical examination and our in-house diagnostic ultrasound service where needed.
Treatment involved stabilising the foot to prevent further deterioration. This can include footwear advice, foot orthoses (specialist insoles) and custom Richie Brace therapy.
What is it and what are the symptoms?
Adult Acquired Flat Foot Deformity (AAFFD) is a progressive flattening of the medial (inside) arch of the foot, very often with pain and loss of normal function in a number of areas around the foot and ankle.
A progressively flattening foot is of course the main sign of this problem but the location of associated pain can vary significantly from person to person as many tissues around the ankle and hindfoot can play a part (our Podiatrists can guide you through which parts are a problem). Common features may include a sense of losing mobility - the foot may feel stiff and less "propulsive" than it once did and may ache until you get moving. You may also find this is having a knock-on effect for how the rest of the body is moving. Both the inside (medial) and outside (lateral) parts of the ankle may be painful as well as the heel and over the top of the midfoot. Again, this can be pinpointed with accuracy in clinic. People also tend to find less supportive shoes become harder to wear without discomfort.
Why does it happen?
As mentioned already, there are a number of tissues in our feet and ankles responsible for controlling how our arch behaves during weightbearing activities. Damage to any one of them (whether slowly over time or due to trauma) may increase the risk of developing a flat foot deformity. The most common of all is damage and elongation the tibialis posterior tendon with the knock-on effect of damage to the spring ligament. And if one tissue suffers, others have to compensate which, if not address may simply progress to more tissues failing to cope properly.
What are the treatment options?
During the initial stage of developing AAFFD, the foot will tend to still have some flexibility and with that gives a lot more conservative treatment options which is why we always stress the importance of seeing someone who knows what they're doing (we like to think that's us!) without delay. If left unmanaged, AAFFD can lead to a very stiff and arthritic foot which, whilst not without hope, also cannot be truly reversed and gives us fewer conservative options.
Either way, treatment can and should almost certainly include the use of well-designed foot orthoses (specialized insoles) to halt the progression of the condition and reduce pain, fully-bespoke Richie Brace therapy if standard foot orthoses aren't enough, footwear advice (flexible shoes are best avoided), exercises to strengthen the muscles that support the arch and management for any knock-on effects needing dealt with such as ultrasound-guided steroid injections for painful joint and tendon problems.
This is a problem we have a special interest in and feel we as an advance podiatry practice we can offer you a great opportunity for success in managing this problem and returning to the activity you love.
